Up to now, no complete study was carried out about the prevalence and location of periapical granuloma and radicular cysts from the point of view of clinical symptoms (e.g. pain and swelling fistula) in Iran. The data was collected from the files available in the Department of Pathology, faculty of Dentistry, Tehran University of Medical Sciences. With a consideration on different therapeutic methods, a proper method was selected. Radicular cyst occurred in 59.3 percent of 324 cases while 45.7 percent were granuloma. The most common incidence of these lesions was in the range of 24-25 years old. The most common location of lesions was the maxillary anterior. Sinus tracts occurred in 74 of all cases. 47.3 percent of these patients have been previously received root canal therapy. It is noticeable that 24 percent of all patients were treated endodontically before surgery. Higher incidence of granuloma occurred in small lesions while cysts were more common in large lesions. 232 of all cases showed one of the clinical symptoms, 16% pain, 35.8% swelling and 22.8% fistula. No symptoms were found in 92 cases.

Purpose: Treatment resistance cases in both endodontal and periodontal diseases are sometimes encountered in spite of a good treatment. These cases may be caused by microbial agents and/or inefficient host responses. The microbial factors need further investigation and host response in discussed in this section.Methods & Materials: Thirty two articles and two text were reviewed for this discussion. Conclusion: The main cause of innate and specific immune system involvement in refractory periapical Periodontitis are microbial factors, where as in refractory Periodontitis the bacterial factor is less prominent and cigarette smoking is considered the main factor with emotional stressors micronutrient deficiency and herpes viruses being contributing factors.

One of the special kinds of periodontal disease is rapidly progressive Periodontitis (RPP). This form of Periodontitis is an aggressive disease, which results in bone destruction and loss of periodontal attachment 4 to 5 times more than adult Periodontitis or slowly progressive Periodontitis. The purpose of this study was to investigate the presence of Actinobacillus actinomyctem comitans (Aa) in RPP patients. A total number of sixty samples was collected from 15 patients with RPP and cultured in anaerobic conditions. Results showed the presence of Aa in 13 patients (86.7%), while 29 samples were Aa positive (48.3%). Two of the RPP patients (13.3%) were Aa negative even after two times bacterial culturing.

Periodontal treatment modalities vary in a wide range, from nonsurgical scaling and root planning to invasive surgical ones such as bone graft and guided tissue regeneration. In all these procedures drug medications or mouth washes are as supportive additive therapies which seems to enhance outcomes or maintain the treatment achievements; additionally, nowadays laser treatment and photodynamic therapy also have gained much attention in periodontal treatments also yet as a supportive modality to conventional therapies. In present study we review and categorize all nonsurgical therapies introduced for periodontal or gingival diseases in evidence-based media and discuss the effectiveness of each upon the results of previous surveys. In present study we review and categorize all nonsurgical therapies introduced for periodontal or gingival diseases in evidence-based media and discuss the effectiveness of each upon the results of previous surveys.

Background: Interleukin-29 (IL-29) is one of the cytokines which has immunomodulatory properties and might play a role in the pathogenesis of periodontal diseases. The aim of this study was an immunohistochemical analysis of IL-29 in gingival tissues of chronic and aggressive Periodontitis. Materials and Methods: In this cross-sectional study based on clinical evaluation and inclusion and exclusion criteria, 20 patients with generalized chronic Periodontitis, 13 patients with generalized aggressive Periodontitis, and 20 periodontally healthy individuals were enrolled. Gingival tissue samples were obtained during periodontal flap and crown lengthening surgery in periodontal patients and healthy individuals, respectively. Tissue samples were examined to determine the level of IL-29 expression by immunohistochemistry. The data were analyzed using SPSS and paired t-test, ANOVA test, and Tukey’ s test (P < 0. 05). Results: A total of 53 participants (34 females and 19 males) were enrolled in this study. IL-29 expression in the connective tissue of the patient groups was more than the healthy one (P < 0. 001). In the aggressive Periodontitis group, there was a significant increase of IL-29 expression compared to the other two groups, but there was no significant difference between the chronic Periodontitis and healthy groups. Conclusion: According to the results of this study, IL-29 expression was increased in the gingival tissue of aggressive and chronic Periodontitis. IL-29 local expression in aggressive Periodontitis is higher than the chronic Periodontitis and healthy groups, which could suggest the role of IL-29 in the etiopathogenesis of aggressive Periodontitis.

Background: Visfatin, also known as nicotinamide phosphoribosyltransferase, has been suggested as a pro‑ inflammatory and immunomodulating marker for Periodontitis. The aim of this study was an immunohistochemical analysis of visfatin in gingival tissues of patients with chronic Periodontitis and aggressive Periodontitis. Materials and Methods: In this cross‑ sectional study based on clinical evaluation and inclusion and exclusion criteria. Twenty patients with generalized chronic Periodontitis, 13 patients with generalized aggressive Periodontitis, and 20 periodontally healthy individuals enrolled. Gingival tissue samples were obtained during periodontal flap surgery and crown lengthening surgery in periodontal patients and healthy group, respectively. Tissue samples were transferred to a pathology laboratory to determine the degree of inflammatory infiltration by hematoxylin and eosin staining and the level of visfatin expression by immunohistochemistry. The data were analyzed using SPSS version 20 statistical software and paired t‑ test, Mann– Whitney test, and Spearman rank correlation coefficient. P < 0. 05 was considered statistically significant. Results: Inflammation grading and visfatin expression were significantly higher in periodontally diseased gingiva compared to the control group (P < 0. 05). However, no significant difference was found between two diseased groups. The relationship between inflammation grading and visfatin expression in aggressive Periodontitis group was statistically significant, positive and relatively strong (P = 0. 025, r = 0. 617). However, no significant relationship has been found between visfatin expression and inflammation grading in the chronic periodontitits and control groups (P > 0. 05). Conclusion: Visfatin expression was increased in gingival tissues of chronic Periodontitis and aggressive Periodontitis patients. Hence, visfatin may have a role in the etiopathogenesis of chronic Periodontitis and aggressive Periodontitis.

Background. Preventive dentistry, including supportive periodontal therapy (SPT), is one of the most critical areas of attention. Despite SPT’ s importance in the long-term success of periodontal treatment, the patients’ adherence to it is weak. The present study aimed to evaluate of periodontal disease’ s recurrence rate and its related factors in periodontal patients without regular follow-up. Methods. A cross-sectional study was set in a specialized periodontics clinic in Tehran, Iran. Patients with Periodontitis who completed periodontal therapy during 2014– 2005 and did not adhere to the maintenance phase were evaluated. The periodontal history of the patients was updated. The previous diagnoses of patients according to their previous periodontal charts were revised by AAP 2015 criteria. Then, periodontal parameters were assessed, and current periodontal status was evaluated. Statistical analyses consisted of Fisher’ s exact test, t-test, Man-Whitney test, and Kruskal-Wallis test. Spearman’ s correlation coefficient was used to assess the relationship between factors and variables. Results. Fifty patients were evaluated, including 29 males and 21 females. There was a significant relationship between the initial diagnosis and recurrence rate of Periodontitis (P=0. 017). There was also a significant relationship between the recurrence of Periodontitis and the years elapsed since the initial treatment (P=0. 027, r = 0. 353). Smoking significantly affected tooth loss (P=0. 001). Conclusion. Patients with severe Periodontitis need more attention to participate in supportive periodontal care. The patients must be aware of the disadvantages of neglecting this phase and be reminded of regular follow-up.